Healthcare Provider Details

I. General information

NPI: 1013369669
Provider Name (Legal Business Name): STEPHANIE RAE BARNHART PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2016
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 W 140TH ST STE 100
BURNSVILLE MN
55337-4835
US

IV. Provider business mailing address

3500 AMERICAN BLVD W STE 300
BLOOMINGTON MN
55431-4442
US

V. Phone/Fax

Practice location:
  • Phone: 952-435-0303
  • Fax: 952-892-5166
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number12143
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: